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ORIGINAL ARTICLE11-29-2022
Outlining the therapeutic itineraries of children with disabilities in the professional health care subsystem
- Andreia Chaves Farias
, - Evanira Rodrigues Maia ,
- Milena Silva Costa ,
- Maria Rosilene Cândido Moreira ,
- Joseph Dimas de Oliveira , [ … ],
- Antonio Germane Alves Pinto
Abstract
ORIGINAL ARTICLEOutlining the therapeutic itineraries of children with disabilities in the professional health care subsystem
Revista Brasileira de Enfermagem. 2022;75(3):e20210169
DOI 10.1590/0034-7167-2021-0169
- Andreia Chaves Farias ,
- Evanira Rodrigues Maia ,
- Milena Silva Costa ,
- Maria Rosilene Cândido Moreira ,
- Joseph Dimas de Oliveira ,
- Antonio Germane Alves Pinto
Views0See moreABSTRACT
Objectives:
to identify the outlining of therapeutic itineraries of families of children with disabilities in the professional health care subsystem.
Methods:
qualitative research carried out in two specialized services in the state of Ceará, with 41 family members interviewed using the life path technique and reports submitted to descending hierarchical classification and similitude analysis, with the help of the IRaMuTeQ software and the theoretical framework of health care systems.
Results:
the classes described the families’ itineraries in five paths, related to faith, support structures, medical behaviors, professionals, and health services. The professional subsystem stood out as deficient in outlining the therapeutic itinerary for access to health care for children with disabilities, without promoting integration between services in the Care Network.
Final considerations:
the families’ therapeutic itineraries showed homogeneous discourse with themes related to the care of professionals and spiritual aspects.
- Andreia Chaves Farias
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ORIGINAL ARTICLE11-29-2022
Undernutrition and associated factors in primary schoolchildren in Lokossa, Benin: a cross-sectional study
- Herbert Sagbo ,
- Sandhi Maria Barreto ,
- Aline Bárbara Pereira Costa ,
- Larissa Loures Mendes ,
- Nagham Khanafer , [ … ],
- Luana Giatti
Abstract
ORIGINAL ARTICLEUndernutrition and associated factors in primary schoolchildren in Lokossa, Benin: a cross-sectional study
Revista Brasileira de Enfermagem. 2022;75(3):e20210254
DOI 10.1590/0034-7167-2021-0254
- Herbert Sagbo ,
- Sandhi Maria Barreto ,
- Aline Bárbara Pereira Costa ,
- Larissa Loures Mendes ,
- Nagham Khanafer ,
- Luana Giatti
Views1See moreABSTRACT
Objectives:
to estimate the prevalence of stunting and thinness and sociodemographic, household, family, dietary, and scholar associated factors in schoolchildren living in Lokossa-Benin.
Methods:
a survey conducted in a probabilistic sample (n=615) of primary schoolchildren (8-17 years), from 12/2018 to 01/2019, using structured questionnaire and 24-hour dietary recall. Thinness and stunting were defined as Height-for-age and Body Mass Index-for-age below-2 standard deviations, respectively. Associations were estimated by chi-square test and logistic regression.
Results:
thinness and stunting prevalence was 13.1% (95%CI:9.0-18.7) and 25.5% (95%CI:20.6-31.2), respectively. Odds of thinness were higher among older schoolchildren and those who experienced hunger at school. Odds of stunting increased with age, low diet diversity, experiencing hunger at school, and having school meal five days a week (OR:2.09; 95%CI:1.29-3.36).
Conclusions:
stunting was the most common problem. Older schoolchildren and those with food deprivation or poor diet diversity were the most affected.
- Herbert Sagbo
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ORIGINAL ARTICLE11-29-2022
Factors associated with bronchopulmonary aspiration: a national-based study
- Jaqueline Helena Tanner ,
- Cristina Mara Zamarioli ,
- Magda Machado de Miranda Costa ,
- Heiko Thereza Santana ,
- Ana Clara Ribeiro Bello dos Santos , [ … ],
- Fernanda Raphael Escobar Gimenes
Abstract
ORIGINAL ARTICLEFactors associated with bronchopulmonary aspiration: a national-based study
Revista Brasileira de Enfermagem. 2022;75(3):e20210220
DOI 10.1590/0034-7167-2021-0220
- Jaqueline Helena Tanner ,
- Cristina Mara Zamarioli ,
- Magda Machado de Miranda Costa ,
- Heiko Thereza Santana ,
- Ana Clara Ribeiro Bello dos Santos ,
- Cleide Felicia de Mesquita Ribeiro ,
- Fernanda Raphael Escobar Gimenes
Views0See moreABSTRACT
Objectives:
to determine the prevalence of bronchopulmonary aspiration in the Brazilian scenario, the factors associated with the incident and the variables associated with death.
Methods:
a cross-sectional and analytical study, carried out from analysis of notifications of incidents related to bronchopulmonary aspiration of the Health Surveillance Notification System, from January 2014 to December 2018.
Results:
of the 264,590 notifications, 553 referred to aspiration, whose prevalence rate was 0.21%. There was an association between the event and age, ethnicity, main medical diagnosis, country region, service type, health unit and consequences for patients. Furthermore, four independent predictor variables for death were found: living in the North or South regions, being elderly and receiving healthcare at night.
Conclusions:
the prevalence rate of bronchopulmonary aspiration was small, but with a negative impact on patients.
- Jaqueline Helena Tanner
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ORIGINAL ARTICLE11-29-2022
Professional burnout of nursing team working to fight the new coronavirus pandemic
- Ana Maria Müller de Magalhães ,
- Denilse Damasceno Trevilato ,
- Daiane Dal Pai ,
- Amanda da Silveira Barbosa ,
- Natascha Monteiro Medeiros , [ … ],
- João Lucas Campos de Oliveira
Abstract
ORIGINAL ARTICLEProfessional burnout of nursing team working to fight the new coronavirus pandemic
Revista Brasileira de Enfermagem. 2022;75:e20210498
DOI 10.1590/0034-7167-2021-0498
- Ana Maria Müller de Magalhães ,
- Denilse Damasceno Trevilato ,
- Daiane Dal Pai ,
- Amanda da Silveira Barbosa ,
- Natascha Monteiro Medeiros ,
- Victória Gabech Seeger ,
- João Lucas Campos de Oliveira
Views0See moreABSTRACT
Objective:
to identify burnout and associated factors among nursing workers working in coping with COVID-19.
Methods:
a cross-sectional study, developed in four hospitals in a capital in southern Brazil. Sample (n=499) composed of nurses and nursing technicians/assistants, who answered an online form containing socio-occupational characterization and the Maslach Burnout Inventory. Descriptive and inferential statistical analysis was performed, including multiple comparison tests.
Results:
burnout was identified in 60 (12%) workers, with no significant difference between hospitals, but with a difference in dimensions between them. In the emotional exhaustion dimension, a higher proportion (52.9%) was found at a moderate level. Prevalence of high level of professional achievement of 95.4% was identified.
Conclusion:
the presence of burnout was significantly prevalent among nurses and females. It reinforces the need to develop strategies to promote the health of nursing workers, providing improvement in health services and reduction of care and labor risks.
- Ana Maria Müller de Magalhães
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ORIGINAL ARTICLE11-29-2022
Changes implemented in the work environment of nurses in the COVID-19 pandemic
- José Luís Guedes dos Santos ,
- Fernando Henrique Antunes Menegon ,
- Gustavo Baade de Andrade ,
- Etiane de Oliveira Freitas ,
- Silviamar Camponogara , [ … ],
- Alacoque Lorenzini Erdmann
Abstract
ORIGINAL ARTICLEChanges implemented in the work environment of nurses in the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2022;75:e20201381
DOI 10.1590/0034-7167-2020-1381
- José Luís Guedes dos Santos ,
- Fernando Henrique Antunes Menegon ,
- Gustavo Baade de Andrade ,
- Etiane de Oliveira Freitas ,
- Silviamar Camponogara ,
- Alexandre Pazetto Balsanelli ,
- Alacoque Lorenzini Erdmann
Views0See moreABSTRACT
Objective:
to describe the changes implemented in the work environment of nurses in university hospitals considering the COVID-19 pandemic.
Methods:
this qualitative and descriptive research was developed from an online survey with 75 nurses from three Brazilian university hospitals. Data processing occurred through textual analysis with the aid of software IRAMUTEQ.
Results:
five semantic classes were obtained: Organization of units for exclusive care of patients with COVID-19; Adaptations in the use of personal protective equipment; Physical structure adaptation; Care flow institution; Increased number of beds and training courses. Final considerations: the results show the effort of healthcare and nursing professionals/managers in the development of structural adaptations and reorganizations of care processes, in the hospital context, to respond with quality and efficiency to the demands arising from the COVID-19 pandemic.
- José Luís Guedes dos Santos
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EXPERIENCE REPORT11-29-2022
Virtualization of the Brazilian Nursing Week in the COVID-19 pandemic: the novelty and the tangible
- Luiza Mara Correia ,
- Ricardo de Mattos Russo Rafael ,
- Mercedes Neto ,
- Juliana Amaral Prata ,
- Magda Guimarães de Araujo Faria
Abstract
EXPERIENCE REPORTVirtualization of the Brazilian Nursing Week in the COVID-19 pandemic: the novelty and the tangible
Revista Brasileira de Enfermagem. 2022;75:e20201203
DOI 10.1590/0034-7167-2020-1203
- Luiza Mara Correia ,
- Ricardo de Mattos Russo Rafael ,
- Mercedes Neto ,
- Juliana Amaral Prata ,
- Magda Guimarães de Araujo Faria
Views0See moreABSTRACT
Objective:
to report the virtualization experience of the 81st Brazilian Nursing Week of a public university in the state of Rio de Janeiro.
Methods:
an experience report with descriptive approach on the planning and virtual operationalization of a traditional nursing event, which took place in May 2020.
Results:
the event had 543 entries and 39 activities were offered, 3 panels with the presence of international guests, 1 national conference, 3 thematic roundtable discussions, 9 roundtable discussions involving projects and extension leagues, 5 cultural activities and 17 activities in social networks (lives and videos). Final considerations: the virtualization of the 81st Brazilian Nursing Week brought the learning and appropriation of new ways of debating nursing in times of physical isolation, which will contribute to an immediate future in social and work relations as well as to the collaborative construction of knowledge.
- Luiza Mara Correia
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ORIGINAL ARTICLE11-29-2022
Reflections on nursing and COVID-19 in light of health education
- Patricia Neyva da Costa Pinheiro ,
- Edna Johana Mondragón-Sánchez ,
- Maria Isabelly Fernandes da Costa ,
- Icleia Parente Rodrigues
Abstract
ORIGINAL ARTICLEReflections on nursing and COVID-19 in light of health education
Revista Brasileira de Enfermagem. 2022;75:e20201305
DOI 10.1590/0034-7167-2020-1305
- Patricia Neyva da Costa Pinheiro ,
- Edna Johana Mondragón-Sánchez ,
- Maria Isabelly Fernandes da Costa ,
- Icleia Parente Rodrigues
Views0See moreABSTRACT
Objective:
To reflect on the nursing and pandemic of COVID-19 considering health education, health promotion, and the Ottawa Charter action areas.
Methods:
A theoretical-reflexive study on health education and health promotion concepts and the areas of action presented in the Ottawa Charter.
Results:
Educational actions are present in the contexts of epidemics and pandemics, as well as in the work of nurses, who need to be increasingly based on dialogue and individual and collective empowerment to enable users to adopt healthy and preventive behaviors – in this case, concerning COVID19. However, this professional needs effective and efficient public policy actions and measures based on scientific assumptions of health promotion. Final considerations: The actions of health education need to be increasingly valued because knowledge can be considered the first “vaccine” to combat any pandemic.
- Patricia Neyva da Costa Pinheiro
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ORIGINAL ARTICLE11-26-2022
Factors associated with suicide ideation of healthcare university students
- Girliani Silva de Sousa ,
- Barbara Moreira Duarte Ramos ,
- Luis Antônio Batista Tonaco ,
- Amanda Márcia dos Santos Reinaldo ,
- Maria Odete Pereira , [ … ],
- Nadja Cristiane Lappann Botti
Abstract
ORIGINAL ARTICLEFactors associated with suicide ideation of healthcare university students
Revista Brasileira de Enfermagem. 2022;75:e20200982
DOI 10.1590/0034-7167-2020-0982
- Girliani Silva de Sousa ,
- Barbara Moreira Duarte Ramos ,
- Luis Antônio Batista Tonaco ,
- Amanda Márcia dos Santos Reinaldo ,
- Maria Odete Pereira ,
- Nadja Cristiane Lappann Botti
Views0See moreABSTRACT
Objectives:
to analyze the factors associated with suicidal ideation in students from healthcare graduation courses.
Methods:
quantitative, cross-sectional study, with 251 students from the courses of radiology, speech-language therapy, medicine, nutrition, health service management, and nursing, from a federal higher education institution in the Southeast of Brazil. Data were collected from August to October 2019, using an electronic questionnaire.
Results:
the prevalence of suicidal ideation among participants was 26.33%. In the final logistic regression model, only depressive symptoms were associated with suicidal ideation. Having symptoms of depression increased the chances of suicidal ideation 2.6 times.
Conclusion:
the high prevalence of suicidal ideation and its associated factors constitutes a situational diagnosis that demands the elaboration of public and institutional policies, focused on the promotion and attention to the mental health of the students.
- Girliani Silva de Sousa
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ORIGINAL ARTICLE07-13-2020
Mental health of nursing in coping with COVID-19 at a regional university hospital
- Eduardo Bassani Dal’Bosco ,
- Lara Simone Messias Floriano ,
- Suellen Vienscoski Skupien ,
- Guilherme Arcaro ,
- Alessandra Rodrigues Martins , [ … ],
- Aline Cristina Correa Anselmo
Abstract
ORIGINAL ARTICLEMental health of nursing in coping with COVID-19 at a regional university hospital
Revista Brasileira de Enfermagem. 2020;73:e20200434
DOI 10.1590/0034-7167-2020-0434
- Eduardo Bassani Dal’Bosco ,
- Lara Simone Messias Floriano ,
- Suellen Vienscoski Skupien ,
- Guilherme Arcaro ,
- Alessandra Rodrigues Martins ,
- Aline Cristina Correa Anselmo
Views0See moreABSTRACT
Objective:
to identify prevalence and factors associated with anxiety and depression in nursing professionals who work to cope with COVID-19 at a university hospital.
Methods:
a cross-sectional observational study using a sociodemographic questionnaire and Hospital Anxiety and Depression Scale, with 88 nursing professionals. Data were analyzed using absolute and relative frequency and Statistical Package for the Social Sciences.
Results:
there was prevalence of anxiety (48.9%) and depression (25%). The majority of the sample consisted of women over 40 years old, married or in a common-law marriage, white, with higher education or graduate degree, with an income above 3,000.00 reais, public servants, working 40 hours a week and working in the hospital from 1 to 5 years.
Conclusion:
we must consider the impact on mental health nursing caused by COVID-19 and intervene with coping strategies to minimize the suffering of professionals.
- Eduardo Bassani Dal’Bosco
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REFLECTION04-22-2020
Thematic content analysis using ATLAS.ti software: Potentialities for researchs in health
Revista Brasileira de Enfermagem. 2020;73(3):e20190250
Abstract
REFLECTIONThematic content analysis using ATLAS.ti software: Potentialities for researchs in health
Revista Brasileira de Enfermagem. 2020;73(3):e20190250
DOI 10.1590/0034-7167-2019-0250
Views0See moreABSTRACT
Objective:
to describe the most important tools of ATLAS.ti Software and to associate them with the procedures of Thematic Content Analysis.
Method:
It is a theoretical reflection of the Content Analysis phases of Laurence Bardin, associating them with software tools Atlas.ti and showing its usefulness for data analysis in qualitative research.
Results:
historical contextualization and the available resources of Atlas.ti software with presentation of health research involving the phases of thematic content analysis.
Final considerations:
The Atlas.ti software assists in the accomplishment of the thematic content analysis being this promising association in health research.
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REFLECTION10-26-2020
Nursing education: challenges and perspectives in times of the COVID-19 pandemic
- Ana Luisa Brandão de Carvalho Lira ,
- Edlamar Kátia Adamy ,
- Elizabeth Teixeira ,
- Francisca Valda da Silva
Abstract
REFLECTIONNursing education: challenges and perspectives in times of the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200683
DOI 10.1590/0034-7167-2020-0683
- Ana Luisa Brandão de Carvalho Lira ,
- Edlamar Kátia Adamy ,
- Elizabeth Teixeira ,
- Francisca Valda da Silva
Views0See moreABSTRACT
Objective:
To discuss the challenges and perspectives of nursing education in times of the COVID-19 pandemic.
Methods:
Reflection study, with theoretical approach based on national and international publications, allied to the experience of researchers in the area of nursing education.
Results:
Four sections are identified: Nursing education: current affairs and perspectives; Education and technologies in time of pandemic: acceleration, alteration and paralysis; Difference between emergency, intentional and remote teaching; the return to the “new normality”: new structuring axes and legal norms.
Final considerations:
The conclusion is that longstanding challenges have emerged with the pandemic, and the processes of acceleration, change and paralysis have marked education in these times. Moreover, epidemiological, technological and psychological aspects should be more valued in the return to activities.
- Ana Luisa Brandão de Carvalho Lira
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ORIGINAL ARTICLE11-13-2020
Social determinants of health and COVID-19 infection in Brazil: an analysis of the pandemic
- Alexandre Medeiros de Figueiredo ,
- Daniela Cristina Moreira Marculino de Figueiredo ,
- Luciano Bezerra Gomes ,
- Adriano Massuda ,
- Eugenia Gil-García , [ … ],
- Antonio Daponte
Abstract
ORIGINAL ARTICLESocial determinants of health and COVID-19 infection in Brazil: an analysis of the pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200673
DOI 10.1590/0034-7167-2020-0673
- Alexandre Medeiros de Figueiredo ,
- Daniela Cristina Moreira Marculino de Figueiredo ,
- Luciano Bezerra Gomes ,
- Adriano Massuda ,
- Eugenia Gil-García ,
- Rodrigo Pinheiro de Toledo Vianna ,
- Antonio Daponte
Views0See moreABSTRACT
Objective:
To analyze the influence of socioeconomic, demographic, epidemiological factors, and the health system structure in the evolution of the COVID-19 pandemic in Brazil.
Methods:
Ecological study with variables extracted from databases, having the incidence and mortality by COVID-19 until August 23, 2020, in Brazilian states, as response variables. The magnitude of the associations was estimated using Spearman’s correlation coefficient and multiple regression analysis.
Results:
In the Brazilian states, 59.8% of variation in the incidence of COVID-19 was justified by income inequality, significant home densification, and higher mortality. In the case of mortality, those same variables explained 57.9% of the country’s variations in federal units.
Conclusion:
Our results indicate that socioeconomic factors influenced the evolution and impact of COVID-19 in Brazil. Thus, we suggest comprehensive actions to ensure economic conditions and strengthening of health networks for populations with socioeconomic vulnerability.
- Alexandre Medeiros de Figueiredo
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ORIGINAL ARTICLE06-27-2019
Validation of a booklet on self-care with the diabetic foot
- Yara Lanne Santiago Galdino ,
- Thereza Maria Magalhães Moreira ,
- Antonio Dean Barbosa Marques ,
- Francisca Alexandra Araújo da Silva
Abstract
ORIGINAL ARTICLEValidation of a booklet on self-care with the diabetic foot
Revista Brasileira de Enfermagem. 2019;72(3):780-787
DOI 10.1590/0034-7167-2017-0900
- Yara Lanne Santiago Galdino ,
- Thereza Maria Magalhães Moreira ,
- Antonio Dean Barbosa Marques ,
- Francisca Alexandra Araújo da Silva
Views0See moreABSTRACT
Objective:
to describe the validation of the booklet on self-care with the feet of people with diabetes.
Method:
methodological study, focusing on the validation of a printed booklet. The content and appearance of the booklet was validated by 23 judges divided into three groups: 11 content and appearance, seven technicians and five of the area of design and marketing. The appearance was validated by 30 people with type 2 Diabetes Mellitus.
Results:
the judges in the nursing area allowed the validation of material with a Content Validity Index (CVI) of 0.99, judges in the area of design and marketing with Suitability Assessment of Materials (SAM) of 99.2% and the target audience with concordance index of 99.4%.
Conclusion:
the educational booklet proved to be valid and reliable educational material to be used in order to promote compliance with self-care with the feet of people with Diabetes Mellitus.
- Yara Lanne Santiago Galdino
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ORIGINAL ARTICLE08-10-2020
Braden Scale in pressure ulcer risk assessment
Revista Brasileira de Enfermagem. 2020;73(6):e20190413
Abstract
ORIGINAL ARTICLEBraden Scale in pressure ulcer risk assessment
Revista Brasileira de Enfermagem. 2020;73(6):e20190413
DOI 10.1590/0034-7167-2019-0413
Views0See moreABSTRACT
Objective:
To analyze the applicability of the Braden Scale to individuals admitted to an Intensive Care Unit (ICU) with the nursing diagnosis Impaired Physical Mobility, in its prediction potential to develop pressure ulcer (PU).
Methods:
A cross-sectional, quantitative study that evaluated all patients hospitalized in an ICU between November 2016 and February 2017, with the Braden Scale.
Results:
The prevalence of PU was 35.8% (24/67), in male individuals 58.3% (14/24), diagnosed with ischemic CVA 51.9% (12/27), and with hemorrhagic CVA 7.4% (2/27). Among patients classified at severe risk of developing pressure ulcer, 83.3% (20/53) developed it, and 76.7% (33/53) did not develop it.
Conclusion:
The performance of the Braden Scale showed a balance between sensitivity and specificity, confirming it as a better predictive risk assessment instrument in this group of patients.
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ORIGINAL ARTICLE02-27-2020
Prevalence of symptoms and quality of life of cancer patients
- Marina de Góes Salvetti ,
- Caroline Silva Pereira Machado ,
- Suzana Cristina Teixeira Donato ,
- Adriana Marques da Silva
Abstract
ORIGINAL ARTICLEPrevalence of symptoms and quality of life of cancer patients
Revista Brasileira de Enfermagem. 2020;73(2):e20180287
DOI 10.1590/0034-7167-2018-0287
- Marina de Góes Salvetti ,
- Caroline Silva Pereira Machado ,
- Suzana Cristina Teixeira Donato ,
- Adriana Marques da Silva
Views0See moreABSTRACT
Objectives:
to analyze the prevalence of symptoms and their relationship with the quality of life of cancer patients.
Methods:
this is a cross-sectional study with 107 patients evaluated using a sociodemographic instrument, the hospital anxiety and depression scale (HADS) and the quality of life scale (EORTC-QLQ-C30). Pearson’s correlation test was used to evaluate the relationship between symptoms and quality of life.
Results:
prevalence of female patients (56.1%), 55 years as the mean age and 10 years of schooling. Fatigue (76.6%), insomnia (47.7%), pain (42.1%), loss of appetite (37.4%), anxiety (31.8%) and depression (21.5%) were identified. Anxiety and depression symptoms presented a negative correlation with quality of life and positive correlation with physical symptoms.
Conclusions:
fatigue, insomnia, pain and loss of appetite were the most common and most intense symptoms. Anxiety and depression symptoms presented a negative correlation with quality of life and positive correlation with physical symptoms.
- Marina de Góes Salvetti
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REVIEW03-24-2021
Strategies of active learning methodologies in nursing education: an integrative literature review
- Joyce Fernanda Soares Albino Ghezzi ,
- Elza de Fátima Ribeiro Higa ,
- Monike Alves Lemes ,
- Maria José Sanches Marin
Abstract
REVIEWStrategies of active learning methodologies in nursing education: an integrative literature review
Revista Brasileira de Enfermagem. 2021;74(1):e20200130
DOI 10.1590/0034-7167-2020-0130
- Joyce Fernanda Soares Albino Ghezzi ,
- Elza de Fátima Ribeiro Higa ,
- Monike Alves Lemes ,
- Maria José Sanches Marin
Views0See moreABSTRACT
Objectives:
to analyze the scientific evidence on the strategies of active learning methodologies used in the training of nurses, as well as their contributions and obstacles in training.
Methods:
integrative literature review conducted with 33 selected articles in the Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Literature in Health Sciences, Nursing Database, Scopus, Web of Science and Education Resources Information Center databases.
Results:
among the strategies, simulation, problem-based learning and flipped classroom were highlighted. The active search, the integration of theory and practice and group work were examples of contributions to the training of nurses. However, the lack of preparation of the actors and the lack of structural support contribute to the dissatisfaction of the students.
Final Considerations:
the active learning methodology places the student at the heart of the learning process, favors critical thinking and the ability to make decisions.
- Joyce Fernanda Soares Albino Ghezzi
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